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Vaginal delivery - discharge

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You are going home after a vaginal birth. You may need help caring for yourself and your newborn. Talk to your partner, parents, in-laws, or friends.

What to Expect at Home

You may have bleeding from your vagina for up to 6 weeks. Early on, you may pass some small clots when you first get up. Bleeding will slowly become less red, then pink, and then you will have more of a yellow or white discharge. The pink discharge is called lochia.

In most cases, bleeding decreases the most during the first week. It may not stop completely for several weeks. It is not uncommon to have an increase in red bleeding around 7 to 14 days, when the scab forms over the spot where your placenta was shed.

Your menstrual period is likely to return in:

4 to 9 weeks after your delivery if you're not breastfeeding.

3 to 12 months if you are breastfeeding, and perhaps not for several weeks after you completely stop breastfeeding.

If you choose to use a contraceptive, ask your provider the effect of the contraceptive on the return of your menses.

You may lose up to 20 pounds (9 kilograms) over the first 2 weeks after having your baby. After that, weight loss of around one half pound (250 grams) per week is best. Your health care provider can explain more about losing weight after pregnancy.

Your uterus will be hard and round and can most often be felt near the navel shortly after birth. It will get smaller very quickly, and after a week will be difficult to feel abdominally. You may feel contractions for a few days. They are most often mild but can be stronger if you have already had several babies. Sometimes, they can feel like labor contractions.

If you are not breastfeeding, breast engorgement may continue for a few days.

Wear a supportive bra 24 hours a day for the first 1 to 2 weeks.

Avoid any nipple stimulation.

Use ice packs to help with the discomfort.

Take ibuprofen to decrease pain and inflammation.

You will need a checkup with your provider in 4 to 6 weeks.

Take tub baths or showers, using only plain water. Avoid bubble baths or oils.

Episiotomy Care

Most women heal from an episiotomy or lacerations without problems, although it may take several weeks. Your stitches do not need to be removed. Your body will absorb them.

You can return to normal activities, such as light office work or house cleaning, and walking, when you feel ready. Wait 6 weeks before you:

Use tampons

Have sex

Do impact exercises, such as jogging, dancing, or lifting weights

To avoid constipation (hard stools):

Eat a high-fiber diet with plenty of fruits and vegetables

Drink 8 cups (2 liters) of water a day to prevent constipation and bladder infections

Use a stool softener or bulk laxative (not enemas or stimulating laxatives)

Other Self-care

Try eating smaller meals than normal and have healthy snacks in between.

Any hemorrhoids you develop should slowly decrease in size. Some may go away. Methods that may help your symptoms include:

Warm tub baths

Cold compresses over the area

Over-the-counter pain relievers

Over-the-counter hemorrhoid ointments or suppositories (ALWAYS talk to your provider before using any suppositories)

Exercise can help your muscles and improve your energy level. It can help you sleep better and relieve stress. It may help prevent postpartum depression. In general, it's safe to start gentle exercises a few days after a normal vaginal delivery -- or when you feel ready. Aim for 20 to 30 minutes a day at first, Even 10 minutes a day can help. If you feel any pain, stop exercising.

You can start sexual activity around 6 weeks after delivery, if the discharge or lochia has stopped.

Women who breastfeed may have a lower sex drive than normal, along with vaginal dryness and pain with intercourse. This is because breastfeeding lowers hormone levels. The same drop in hormones most often prevents your menstrual period from returning for many months.

During this time, use a lubricant and practice gentle sex. If sex is still difficult, talk with your provider. Your provider may recommend a hormone cream that can reduce your symptoms. These changes in your body are temporary. After you are done breastfeeding and your menstrual cycle returns, your sex drive and function should return to normal.

Talk with your provider about contraception after pregnancy before you leave the hospital. You may be able to get pregnant as soon as 4 weeks after having a baby. It is important to use effective contraception during this time.

In the days or even months after delivery, some moms feel sad, disappointed, tired, or withdrawn. Many of these feelings are normal, and they often will go away.

References

American College of Obstetricians and Gynecologists; Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists' Task Force on hypertension in pregnancy. Obstet Gynecol. 2013;122(5):1122-1131. PMID: 24150027 www.ncbi.nlm.nih.gov/pubmed/24150027.

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